Shaking/Spasms/Tremors

I am worried about my little Phoebe.

I'll give some background - she is only 8 but was diagnosed with CRF and asthma 2 years ago - she had no treatment for a year cuz my old vet is an idiot. I took her for a second opinion on the asthma a little over a year ago and that is when I found out how serious her CRF was and we started treating both the asthma and CRF. She is also being treated as of 2 months ago for allergies and high blood pressure.

Here are her current meds:
SubQ fluids (LRS) 150 mL 1x/day
Famotidine 2.5 mg 1x/day
Flovent inhaler, 2 puffs 2/day - altho we just cut back to 1x/day as of yesterday
Albuterol inhaler, 2 puffs as needed (which is rare)
Norvasc, 1/4 of a 2.5mg tablet 1x/day
Benazepril, 1/4 of a 5mg tablet 1x/day
Atopica (Cyclosporine), 25mg tablet 1x/day

She was on Flagyl and FortiFlora last week for diarrhea

She has been doing really well until just the past couple of weeks. I think she is being overloaded with meds.

For a couple of weeks now, she has been having slight trembling/shaking of her head as she is falling asleep. This morning it got worse - as she is relaxing, her legs/head will start twitching. And no, it's not the normal twitching they do when falling asleep.

There are 2 vets at my clinic, both are awesome but I prefer one over the other and she is not in today. So I called this AM and he wanted me to videotape it and let him see it, but not bring her in. It has taken me all flipping morning to do this since the files were too large. I finally uploaded it to YouTube and emailed him the links. I just called to let them know to check and have him look at it so I can know if I need to bring her in.

I took her in last week for vomiting/drinking lots of water and her results were good -creatinine was 2.7 (range 0.8-2.4)) - up from 2.5 three months ago, but in good range for past year -was 4.9 before starting treatment a year ago! BUN is 22 (range 16-36)

Ok and here is the thing - I am not working FT now so money is REALLY tight. I'll find a way if I have to but it's not pretty.

I guess I just need some support and encouragement right now. Since I am home a lot more, I sit and stare at her and it makes it all seem worse cuz I see very little thing and over analyze.

I have also been considering going to this holistic vet/nutritionist in the area who is supposed to be really good and does consultation around the world. And she is right here! So maybe I should take advantage of it. I don't know.. Phoebe is soooo sensitive and I feel like I am overwhelming her.

PLUS, the food she eats 80% of the time got recalled and so I have been searching for something decent that will work in addition to her Rx foods.

Why is she twitching and what should I do??!!

Help!!

In my limited experience, Pippin does this when he is in pain, stressed or anxious.
He's been doing it today but he just got home a couple days ago after his PU surgery, so him being a little stressed is normal. He's getting valium for this when he needs it. He seems more comfortable now that the other kitties have finally recognized him and are being, if not nice, at least not mean anymore.
I'm so sorry you are having such stress over your kitty. I know the feeling. They really worry you when they are sick! I had a breakdown last night because he wasn't doing well at all and I felt like it was my fault. Like I should/could be doing more.
I'd be really tempted to bring your girl to the holistic vet/nutritionist. There are a lot of alternative therapies that can give good results, and that's what we are ALL after.
Good luck! I really hope you figure out what the twitching is about.

Devlyn

Oh, I understand your misery... and I don't know why she's twitching, but I think your idea about taking her to the holistic vet is a good one. Even if this little girl's time is short, it may be that a gentler, more natural way of treating her would be more comfortable for her, y'know?

Bless your heart for all you're doing for your kitty. I'm sure she knows how much you love her.

Thanks for the feedback.

After seeing the videos, both my vets said it is subtle and they are not concerned and if I am, I can see a neurologist - well I mean Phoebe can, not ME!

Anyways, I think it is from the Atopica (Cyclosporine) - I've been doing some research online and trying to figure it out. I am going to have a consult with the holistic nutritionist and see what she thinks about getting her on a supplement that could help her asthma and CRF. There is something called Cordyceps that looks promising. Anyone heard of that?

Here are the 2 videos I uploaded to You Tube if anyone wants to see. Do you think I am overreacting??
This one is the head shakes she has been doing recently...

Here is the second video of Phoebe's "tremors/spasms" - it is a couple of minutes long but if you watch the whole thing, it will give you an idea of what it looks like even after she moves and relaxes again. In addition to the tremors, she is doing a rapid "shivering" type of... thing. (esp see 0:45-1:25 - perfect twitching/trembling example).

When Cleo was diagnosed with CRF (nearly 6 1/2 years ago) she did the same thing! She has a very slight quiver or tremor. Hers is full body, a shivering, almost as if she's cold. I posted numerous queries on the CRF-Support group and nearly everyone asked what her potassium levels were. Most thought it was from a low potassium. Cleo's potassium (K+) levels have always been exactly within the normal limits, so it wasn't that. One or two people mentioned that I should supplement her with B complex vitamins. Since B vitamins are water soluable, she could be depleted because of the sub-Q fluids. I purchased Jarrow B-right capsules and have been supplementing her with 1/8 of a capsule daily. (I split each large Jarrow capsule and completely fill an empty #4 gelcap with the contents. This equals approximately 1/8 of a capsule.) Since I started supplementing her with B-complex vitamins, her quivering has nearly disappeared.

Many people on the CRF-support group recommend the Jarrow B-right formula, because it contains methylcobalamin B12 instead of cyanocobalamin B12....it is supposed to be a better form of B12. I just did a Google search with the term "Jarrow B-right" to find a place to purchase it. I get my empty #4 gelcaps from www.spicediscounters.com http://www.spicediscounters.com/gelcaps.html

Supplementing B complex vitamins is probably a good thing to do with CRF. By giving sub-Q fluids, we flush out many of the B vitamins that are taken in by eating. Since they are water soluable, it is difficult, if not impossible, to overdose....excesses are flushed out of the body. B complex vitamins are important in the production of red blood cells, and anemia is often a complication of CRF, so it makes sense to supplement for that reason alone.

Hope this helps!

I will keep your sweet Phoebe in my prayers!

Pookie & the girls

P.S. I just watched the videos. Cleo's quiver looks exactly like Phoebe's when she's laying down!!! Except for the coloring, it could be the same cat!!! Cleo's is easier to feel than it is to see. When she first started doing it, I thought she was shivering from being cold, but she even did it on a heating pad. Since I started supplementing B vitamins, Cleo rarely does it anymore. Good luck! (Oh...my vet didn't think it was anything to worry about either!)

Thank you. I will talk to my vet about that today.

Her appetite has really decreased the past week because if the CRF and I can tell she is not feeling well, so I am calling the vet at 7am and may take her in today.

Just updating the original thread so it doesn't get confusing.

I talked to my vet about the B vitamins and she said not to worry about that yet and if I was concerned to take her to the neurologist - but... but... but.... GAH!

Last Friday we added Cyproheptadine (appetite stimulant) and Metaclopromide (anti-nausea) to her list of meds. I have since started a chart like I use for the shelter cats so I don't get confused - cuz now it's 10 meds and while most are once a day, now I've got twice a day and 3 times a day.

I was so upset earlier today--I'm not working FT and so have no money but I need to do something cuz no matter what my vet says - I know my cat better than anyone and something is just not right!

Talked to my vet this afternoon and I am stopping the Cyproheptadine cuz it is drugging her out and she is acting weird - good news is she has been eating. I just hope it is the med making her weird and not something else.

So I have been going over in my mind, do I
a) take her back to my vet tomorrow to have her looked at again and have her renal profile redone to make sure her values are the same as 2 weeks ago?
b) take her to the neurologist for a consultation and possibly big bucks for testing?
c) have a mobile vet who I know come to the house and examine her here where she will be able to see first hand what I am talking about and tell me if I am crazy or if something is wrong?

I was leaning toward "c" and scheduled an appt for tomorrow afternoon, but the more I think about it, the more I think that this probably IS something neurological and should maybe schedule the neurology consultation.

I don't want it to sound like I am looking for the cheap way out - that's not it at all - I just don't want to waste money you know? If I go to my vet or the mobile vet and they say I need to see a neurologist, than that was money wasted kind of, you know?

I don't know - I keep going over this in my head and doing nine million internet searches to find something, anything that would make this decision as to what to do easier.

Heeeeeeeelllllllllllllppppppppp!!

Couple of quick questions/comments--has she had her blood pressure rechecked since starting all those meds? If it's been two months, a recheck on her BP may be in order. Also, what was the potassium value, and what is the reference range? Just being with in the reference range doesn't mean the value is normal--seniors should be near the middle of the range (usually around 4.4) or higher. If it is below the middle of the range, then it would be good to ask your vet about supplementation (potassium pills are inexpensive and can be purchased from places like Target or any pharmacy).

http://www.felinecrf.org/treatments.htm#low_potassium

My Toby had head shaking a a little like the first video, for years before he went, he didnt have kidney probs, and it didnt seem to bother him. Looking at the second pic, it almost looks like too much dreaming (I would guess that its too many drugs, we get side effects, they must do to). My cat has serious kidney probs but apart from his blood pressure tablet which is essential I dont add anything else, trouble is with all these meds, poor puss cant always tell us what hes feeling. Hope you sort it out.
Best Wishes
Chris

I have absolutely no experience with your problem, but after watching the videos it's apparent that Phoebe is in distress/stress of some sort. I think you're right to be concerned. My Juno has done some sort of a muscle rippling from the time I got her at 4mo. she's now a year. The ripple starts at her shoulders and progresses to her butt. The vet says not to be concerned, but sometimes I wonder.

Originally Posted by cloud_shade

Couple of quick questions/comments--has she had her blood pressure rechecked since starting all those meds? If it's been two months, a recheck on her BP may be in order. Also, what was the potassium value, and what is the reference range? Just being with in the reference range doesn't mean the value is normal--seniors should be near the middle of the range (usually around 4.4) or higher. If it is below the middle of the range, then it would be good to ask your vet about supplementation (potassium pills are inexpensive and can be purchased from places like Target or any pharmacy).

http://www.felinecrf.org/treatments.htm#low_potassium

Click to expand...

Her blood pressure was rechecked a few weeks after starting the meds and yes, it has dropped down to within normal range now.

Her Potassium was 5.3 (range 3.5-5.8)

I had made an appt with the neurologist for this past Wednesday, but my vet talked to him and he wants to see the video first. She knows I am on unemployment now and money is tight, so that was awesome she did that and he agreed to see the video and review her chart!!

It has been better the past few days - but other issues have arisen - I'll have to do a separate post for that.

Anyways, thanks for the feedback and I''ll let you know what the neurologist says.